NPIMap

Organization Active NPI

Duke Facilities, Inc

  • Intellectual Disabilities Intermediate Care Facility
  • Stockton, CA
National Provider Identifier
1962551713
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Intellectual Disabilities Intermediate Care FacilityTaxonomy code 315P00000X
License
55G532 Issued in CA
Legal business name
DUKE FACILITIES, INC
Practice address
403 Goya Dr
Stockton, CA 95207-2246
Phone
(209) 472-7848
NPI assigned
Jan 10, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Mrs. Anita Beth Duke, R.N.P.
Title
Licensee President
Phone
(209) 969-1576

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Intellectual Disabilities Intermediate Care Facility 315P00000X 55G532 CA Primary

Addresses

Primary practice location

403 Goya Dr
Stockton, CA 95207-2246

Mailing address

1150 W Robinhood Dr
Ste 2C
Stockton, CA 95207-5624

Other identifiers 1

IdentifierTypeStateIssuer
LTC61061FMedicaidCA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

Intermediate care facility for individuals with intellectual disabilities certification: CCN 55G532

Name & address match This certification has no NPI in the Medicare enrollment files. CMS publishes enrollment files for six facility types only, so it was connected to this NPI by matching the name and address CMS publishes for it.

Legal name
DUKE FACILITIES, INC #3
Certification status
Active
Provider type (POS)
Intermediate care facility for individuals with intellectual disabilities
Participating since
Jan 19, 2006
Last certification
Oct 10, 2024
Beds
6
Ownership / control type
Other (specify)
Facility address
403 Goya Drive
Stockton, CA 95207

National Provider Directory

National Provider Directory
Tax ID family
Duke Facilities Inc5 organizations share this tax ID, including this one

Other organizations with this tax ID 4

Organizations that report the same tax identification number in the National Provider Directory.

Locations

1150 W Robinhood Dr
Ste 2C
Stockton, CA 95207

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1168387200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1962551713",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1150 W ROBINHOOD DR",
            "address_2": "STE 2C",
            "city": "STOCKTON",
            "state": "CA",
            "postal_code": "952075624",
            "fax_number": "209-474-9260"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "403 GOYA DR",
            "city": "STOCKTON",
            "state": "CA",
            "postal_code": "952072246",
            "telephone_number": "209-472-7848"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DUKE FACILITIES, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-10",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "DUKE",
        "authorized_official_first_name": "ANITA",
        "authorized_official_middle_name": "BETH",
        "authorized_official_title_or_position": "LICENSEE PRESIDENT",
        "authorized_official_telephone_number": "209-969-1576",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "R.N.P."
    },
    "taxonomies": [
        {
            "code": "315P00000X",
            "taxonomy_group": "",
            "desc": "Intermediate Care Facility, Intellectual Disabilities",
            "state": "CA",
            "license": "55G532",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "LTC61061F",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Stockton, CA

Sources for this page

Verify at the official NPI Registry.